We agree with Nicolas Nesseler and colleagues1 that intravenous antibiotics should be the first step in the treatment of infected necrosis. Antibiotics can postpone intervention in patients with infected necrosis until it is walled off. In a small group of patients, antibiotics will be the only treatment required, obviating the need for invasive interventions.2 We have previously shown that this subgroup consists of approximately 3% of patients with infected necrotising pancreatitis.3